Shelby Nassar Gehrmann, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-09750 Issued in NC

Practice address

280 Executive Park Dr Ste 100
Concord, NC 28025-1838

Phone

(704) 237-4240

NPI assigned

Feb 25, 2020

Last updated

Jul 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Shelby Jean Nassar Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1780218131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10711 ANNALEXA LN APT 513",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282770591",
            "telephone_number": "704-280-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251838",
            "telephone_number": "704-237-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEHRMANN",
        "first_name": "SHELBY",
        "middle_name": "NASSAR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-25",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09750",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-09750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "NASSAR",
            "middle_name": "JEAN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Medical Physician Assistant in Concord, NC
• Providers in Concord, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.